Is it Possible to Create a Tablet from Pneumonia? by Igor Klepikov in Open Journal of Cardiology & Heart Diseases

1. Volume 1 - Issue - 1
1/2
Letter to Editor
“Antibiotics alone” remain today the guiding principle of
the treatment of many inflammatory diseases including acute
pneumonia (AP). If this principle of treatment has produced the
expected results, the discussion of this topic would not be required.
However, published results show not only the negative dynamics
of development of purulent complications of the AP, but also the
lack of promising strategies to address this problem [1-4]. Pediatric
pleural empyema has increased substantially over the past 20 years
and reasons for this rise remain not fully explained [5]. In developed
countries 9.5% to 42% of patients with pneumonia are accepted
in hospital due to the ineffectiveness of primary treatment [6].
Nonetheless, the transfer of patients to a hospital does not improve
the results of treatment. Parapneumonic effusions or empyema
affect 2% to 12% of children with pneumonia, and up to 28% of
those requiring hospitalization [7].
Unfortunately, modern recommendations for treatment of АP
and prevention of its complications only lead to suppress microflora
as the main treatment remains antibiotics. Such recommendation
on administration of antibiotics was based on the belief of a
predominant role of specific bacteria in the development of АР. In
recent years, this threat was Streptococcus pneumoniae. However,
the well-known published facts and results have not ended the
debate on etiology of АP. Most of the patients with AP heal without
definitive data confirming etiology of the disease. In our opinion, in
the absence of concrete results, further discussions on etiology of
inflammation in AP are simply groundless.
Bacteriological examination of material from the zone of
inflammation becomes available in case of purulent complications.
But only the results of these studies indicate the participation of
the most diverse etiologic agents in AP. Scientific medicine has
received the most serious blow to its reputation after years of large
scale pneumococcal vaccination of the population in developed
countries. Thus, a statistically significant increase in supportive
complications of AP, contrary to the prediction of their decline,
is still without a proper scientific explanation. Among children
≤18 years of age, the annual empyema-associated hospitalization
rates increased almost 70% between 1997 and 2006, despite
decreases in the bacterial pneumonia and invasive pneumococcal
disease rates. Pneumococcal conjugate vaccine is not decreasing
the incidence of empyema [8]. Despite decrease in pneumococcal
diseases among Utah children, complicated pneumonia/empyema
has increased during the 7-valent pneumococcal conjugate vaccine
era; the causes on increasing rates of empyema are unclear [9].
The discovery of antibiotics was an outstanding achievement in
the past century. Their practical application have saved the lives of
a huge number of patients. Therefore, the importance of antibiotics
in complex medical care to various categories of patients is not in
doubt. At the same time, the use of antibiotics in clinical practice is
such a major transformation that requires a dramatic revision of
the strategy in many specific areas and revaluation of the role and
place of these drugs in the set of medical care. The first stunning
results of antibiotic use were so impressive that deservedly gave
rise to the opinion of their exclusivity and elevated them to the rank
of a panacea for many diseases. But time passed and microflora, as
a biological entity, became able to adapt to this medical aggression.
Antibiotics-resistant microbe strains began to appear as a natural
consequence of such exposure (because the absolute sterilization
of living biological world is impossible, isn’t it?).
Today we already have quite a long list of such resistant
strains and the list is constantly growing. The history of all these
transformations has a second face: a decline in the effectiveness of
antibiotics and the rise of microbial resistance to them has been a
powerful incentive for pharmacologists to develop new and more
active and powerful drugs. Therefore, at present it is impossible
to enumerate by heart all known antibiotics. And here is exposed
the dilemma, which cannot be invisible, and which requires a
debate. On one hand, medical practice regularly receives new and
more powerful antibiotics. On the other, updating the аrsenal of
antimicrobial agents does not prevent the growth of purulent
complications of АР.
Currently, the image of new infectious threats arises.
Respiratory viruses, rather than bacterial pathogens, were most
commonly detected in children hospitalized with pneumonia.
This ground-breaking study shows how badly we need faster,
less-expensive diagnostic tests for doctors to accurately diagnose
the cause of pneumonia so that they can effectively treat it [10].
“The results help to define the role of viruses as major players in
pediatric pneumonia and shows a need for new therapies that can
Igor Klepikov*
Pediatric surgeon, USA
*Corresponding author: Igor Klepikov, Pediatric surgeon, 2116 27th
St. NE Renton, WA 98056, USA, Tel: 1-206-920-9643;
Email:
Submission: September 26, 2017; Published: January 09, 2018
Is it Possible to Create a Tablet from Pneumonia?
Letter to Editor Open J Cardiol Heart Dis
Copyright © All rights are reserved by Igor Klepikov.
CRIMSONpublishers
http://www.crimsonpublishers.com
ISSN 2578-0204

2. How to cite this article: Igor K. Is it Possible to Create a Tablet from Pneumonia?. Open J Cardiol Heart Dis. 1(1). OJCHD.000505. 2018.
DOI: 10.31031/OJCHD.2018.01.000505
Open Journal of Cardiology & Heart Diseases
2/2
Open J Cardiol Heart Dis
Volume 1 - Issue - 1
reduce the severity of viral pneumonia”, says Chris Stockmann, co-
investigator and senior research analyst at the University of Utah.
Among children diagnosed with pneumonia, viral infections were
much more common than bacterial infections (73% vs. 15%), and
respiratory syncytial virus (RSV) was the most commonly detected
pathogen [11]. It is significant that the frequency of detection of
these viruses in healthy people is not statistically different from
their etiological role in acute pneumonia.
If you stick to the old approach in the treatment of АP, the
new information about the etiology of the disease pushes the
pharmacologists towards a new challenge: the need to develop and
create unique group of antiviral drugs. It should be noted that the
principles of solving the problem remains the same and changes
can apply only to tactical efforts. Beginning this way will be a new
round of competitive race between pathogens and pharmaceuticals.
Modern treatment results in АP show that the previous round of
this competition ends not in favour of the creators of the drugs.
Thus, before you start intensive work in this direction, we should
recall well-known facts about the nature of the АP. It is well known
that pneumonia is not a contagious infectious disease and not in
need of appropriate measures for the health and safety [12]. It is
also common knowledge that many people are carriers of the entire
spectrum of microbes that are pathogens of АP. These people feel
healthy and do not need medical attention.
In other words, the presence of a microbe is insufficient for the
occurrence of inflammation in the lung. Such a conclusion is not a
revelation to many experts. Please note, we are not talking about
such dangerous infections as plague, cholera, typhus, smallpox,
etc., which can cause terrible epidemics. Today the problem lies
elsewhere. Current generations of physicians are educated in
respecting microflora and act in accordance with their education.
Training doctors are aware of many medical axioms, which have
a scientific basis, but this knowledge does not affect their general
idea about the nature of the АP. As an example, the following are
some of such axioms are of direct relevance to the development and
dynamics АP:
a. body response to any stimulus, including the initiation of
inflammation, is highly individual and unique;
b. the basis for the inflammatory transformation of the body
tissue is a vascular reaction with a specific sequence;
c. small and big circulation not only have a direct relationship,
but an inverse relationship;
d. among the nonspecific forms of inflammation, AP is the only
process occurring in the system of small circulation;
e. the same medical procedure can have different effects on
inflammation in the small or big circulation;
Therefore, the problem of a guaranteed cure of АP and the
prevention of its purulent complications should be carried out
through a revision of the understandings of the mechanisms of
emergence and subsequent development of the disease. However,
there is another dilemma. On one hand, the new doctrine on the
etiologyofAPnotonlycreatedandarguedformoreoriginalresearch,
but also led to excellent clinical results. A detailed description of the
results of this work can be found in a published book [reference].
On the other hand, the most difficult task in the field of care for
patients with АP will change existing stereotypes. The impact of the
prevailing concept of АP on the mindset of a vast number of experts
will be impossible to fix in a short time. This paradigm remained
dominant for several decades, accompanying health professionals
within their trainig and throughout their career. The obvious
argument for the introduction of new educational programs on АP
is the modern statistics of outcomes in these patients and complete
stagnation in the explanation of failures and negative trends in these
results. How much time may require such retraining, is difficult to
predict. One thing is quite clear, the beginning of this work cannot
be postponed.
References
1. Klepikov I (2017) Acute pneumonia in children: the price of illusions
and delusions. J Pediatr Care 3(1): 4.
2. Klepikov I (2017) Why need a new concept of acute pneumonia. J Tradit
Med Clin Natur 6: 212.
3. https://gehealthcloud.devpost.com/forum_topics/6433-tablet-against-
pneumonia-modern-delusion-igor-klepikov-md-professor
4. Klepikov I (2017) The new doctrine of acute pneumonia-the key to solve
the problem. Journal of Integrative Pediatric Healthcare.
5. Elemraid MA, Thomas MF, Blain AP, Rushton SP, Spencer DA, et al. (2015)
Risk factors for the development of pleural empyema in children. Pediatr
Pulmonol 50(7): 721-726.
6. Pabary R, Balfour Lynn IM (2013) Complicated pneumonia in children.
Breathe 9: 210-222.
7. http://www.uptodate.com/contents/epidemiology-clinical-
presentation-and-evaluation-of-parapneumonic-effusion-and-
empyema-in-children
8. http://pediatrics.aappublications.org/content/125/1/26
9. Ampofo K, Pavia AT, Stockmann CR, Blaschke AJ, Cindy Weng HY, et al.
(2011) Evolution of the epidemiology of pneumococcal disease among
Utah children through the vaccine era. Pediatr Infect Dis J 30(12): 1100-
1103.
10. http://www.cdc.gov/media/releases/2015/p0225-pneumonia-
hospitalizations.html
11. http://healthcare.utah.edu/publicaffairs/news/2015/02/022515_
Childhood_Pneumonia.php
12. Klepikov I (2017) Acute pneumonia in children -illness or infection?
Open Letter to the Editorial Staff. J Infect Non Infect Dis 3: 017.